


Case Notes for Initial Counseling Session: A.J. Crowley

by Euny_Sloane



Category: Good Omens (TV), Good Omens - Neil Gaiman & Terry Pratchett
Genre: Ambiguous Gender, Ambiguous sexuality, Case Notes, Genderqueer, Mental Health Issues, Other, Psychotherapy, References to Depression, Therapy Notes, queer, reference to PTSD, reference to addiction, reference to alcohol misuse, reference to family rejection, reference to toxic family
Language: English
Status: Completed
Published: 2019-08-29
Updated: 2019-08-29
Packaged: 2020-09-28 23:31:02
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 559
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/20434292
Author URL: https://archiveofourown.org/users/Euny_Sloane/pseuds/Euny_Sloane
Summary: An unnamed therapist has written clinical/case/therapy notes about an initial session with Crowley, who has gone to therapy on Aziraphale's recommendation.





	Case Notes for Initial Counseling Session: A.J. Crowley

**Subjective  
**Client reports that their friend A. recommended counseling because, per client, (using air quotes) "I think we've reached the limit on what talking to your plants can do." Client reports they have not had any previous experience with counseling. Discussed client's expectations for counseling; client only indicated trusting A's judgment enough to try it, but has learned "not to expect much" from life. 

Client currently unemployed and indicated their wealth makes employment unnecessary. Client declined to comment further on employment history except to call their previous employer "truly infernal" and express hope never to hear from their former colleagues ever again. 

Client declined to give details on their family life, though implied that client was "one of the world's first truly disappointing children" and is not close to any family members at present. Per client, "they're all hell raisers, basically," and indicated none of them are trustworthy, which client attributes to their upbringing and current social context. 

**Objective  
**Middle aged client with red hair presented in black jeans that appeared to be cut for women, a slim silver scarf/necklace accessory, black tee shirt, and a close tailored black blazer. Dressed moderately appropriately for the weather, with the exception of wearing all black in August. Client declined to remove or explain sunglasses at any point during session, despite this writer's offer to reduce ambient lighting. 

Client irritable, guarded, sarcastic, though otherwise polite, with no evident abnormal perceptions or beliefs. Client changed position frequently in session, rarely sitting facing this writer or entirely upright in chair. 

**Assessment & Plan  
**Client demonstrates several sx of MDD, including excessive sleep, persistent feelings of worthlessness, low energy, low appetite, and frequent restless movement. 

Session focused on exploration of expectations for counseling and developing rapport. In future sessions will further explore client's relationship with A.; details of client's substance use (some indications that client drinks heavily without apparent awareness of chronic impact on mood, etc.); and client's perception of their gender and relationship with A. Client's absolute trust in A. is surprising given client's ruptured family relationships, and suggests both significant intimacy between them and a capacity for attachment. 

At present it appears client is socially isolated and has hobbies limited to walks in the park, growing houseplants and drinking, though client indicated they used to travel and would like to again if for pleasure and not work. Client repeatedly used humor, vague gestures and snarky comments to evade questions, which this writer let pass without comment as our rapport is in development. Encouraged client to go for more walks, as physical activity can be beneficial for mood. 

Client did not self identify as queer though other elements of client's case are suggestive, including the consistency and intensity of client's smile when discussing their friend A., primarily evident around the eyes, suggesting client may prefer to conceal this emotional response. Will have to explore further to assess client's identities/preferences. Potentially connecting client with fellow gardeners and or queer community may be beneficial. 

**Initial diagnosis   
**Major Depressive D/o

Rule out Persistent Depressive D/o  
Rule out PTSD or affective trauma  
Rule out Alcohol Use Disorder  
Rule out SNEK

**Additional:**

Note that client just gestured ambiguously when asked about their preferred pronouns, so will be referred to as they until client clarifies. Client exhibited similar though warmer response when asked about A.'s gender.

**Author's Note:**

> This is the first fanfiction I've ever written and I'm not even sure if it is fanfiction. People say to write what you know and after nearly ten years in the field of mental health, I know how to write case notes even half asleep. If you'd be interested in seeing this for another character in Good Omens, I would be interested to write it! Honestly nobody may ever see this but me. The internet is such a strange place.


End file.
